{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:46:33Z","timestamp":1761677193504,"version":"3.40.5"},"reference-count":21,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Folia Phoniatr Logop"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Introduction: The conventional rigid-90\u00b0 and rigid-70\u00b0 laryngostroboscopy has been so far considered the gold standard in assessing the vibratory behavior of the vocal folds and the glottal closure configuration during phonation. Meanwhile, this rigid laryngostroboscopy is more and more replaced by flexible chip-on-tip systems. The aim of this study was to evaluate the influence of these different endoscopic techniques on glottal closure configuration and on visibility of the complete focal fold length including anterior commissure during phonation. Methods: Twenty-one euphonic subjects were enrolled (mean age 34.6 \u00b1 9.5; m = 10, f = 11). They were examined with the three laryngoscopic techniques (conventional rigid-90\u00b0, rigid-70\u00b0, and flexible chip-on-tip laryngoscopy during low and high voice pitch with soft and loud voice intensity). For evaluating the degree of glottal closure, a modified classification of S\u00f6dersten et al. was applied and the visibility of the anterior commissure was evaluated. The correlation of the three endoscopic techniques was assessed with Cohen and Fleiss\u2019 kappa. Results: In even low loud phonation, the rigid-90\u00b0 and rigid-70\u00b0 endoscopies revealed a complete closure of the glottis in only 47.6% of subjects but with flexible endoscopy in 81%. The complete vocal fold length with anterior commissure was best visible with flexible endoscopy in 90.5% in low-soft and high-soft phonation. The rigid-90\u00b0 endoscopy showed a slight agreement in comparison with the flexible endoscopy in regard to the types of vocal fold closure with a Cohen\u2019s kappa coefficient k = 0.199. The rigid-90\u00b0 endoscopy showed an almost perfect agreement with k = 0.84 when compared to the rigid-70\u00b0 endoscopy. The flexible endoscopy compared to the rigid-70\u00b0 endoscopy showed a fair agreement with k = 0.346. Conclusion: We found mainly corresponding results in both rigid-90\u00b0 and rigid-70\u00b0 endoscopic techniques which can be explained by the same transoral approach with the tongue pulled out, whereas the flexible transnasal endoscopy mainly gives a better view on the anterior commissure. The influence of transorally or transnasally guided endoscopic techniques needs to be considered in interpretation of laryngostroboscopic parameters like vocal fold closure and supraglottal hyperactivity. <\/jats:p>","DOI":"10.1159\/000530454","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T21:00:33Z","timestamp":1680296433000},"page":"324-333","source":"Crossref","is-referenced-by-count":3,"title":["Differences in Glottal Closure and Visibility of the Anterior Commissure during Rigid-90\u00b0, Rigid-70\u00b0, and Flexible Laryngostroboscopy"],"prefix":"10.1159","volume":"75","author":[{"given":"Roland","family":"Paulus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7311-8526","authenticated-orcid":false,"given":"Matthias","family":"Leonhard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-6057","authenticated-orcid":false,"given":"Guan-Yuh","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0637-6880","authenticated-orcid":false,"given":"Annabella","family":"Kurz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9978-6474","authenticated-orcid":false,"given":"Berit","family":"Schneider-Stickler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s004050000299"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s0892-1997(05)80129-8"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199603001-00001"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.3303.601"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2015.12.010"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676108"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1067\/s0892-1997(03)00065-1"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/s0892-1997(05)80252-8"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1177\/001316446002000104"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1037\/h0031619"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1996.tb01079.x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/s0892-1997(97)80014-8"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.557"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200403"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/s0030-6665(05)70241-3"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.09.037"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1159\/000094569"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2010.06.006"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1271631"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3109\/00016489209100796"}],"container-title":["Folia Phoniatrica et Logopaedica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/fpl\/article-pdf\/75\/5\/324\/4024200\/000530454.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/fpl\/article-pdf\/75\/5\/324\/4024200\/000530454.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:24:06Z","timestamp":1745421846000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000530454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,10,3]]},"published-print":{"date-parts":[[2023,10,3]]}},"URL":"https:\/\/doi.org\/10.1159\/000530454","archive":["Portico"],"relation":{},"ISSN":["1021-7762","1421-9972"],"issn-type":[{"type":"print","value":"1021-7762"},{"type":"electronic","value":"1421-9972"}],"subject":[],"published":{"date-parts":[[2023]]}}}